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Got It, Hide thisHernandez AV, Emonds EE, Chen BA, et al. Effect of low-sodium salt substitutes on blood pressure, detected hypertension, stroke and mortality. Heart. 2019;105:953-60.
In patients with or without high blood pressure (hypertension), does using a low-sodium salt substitute reduce blood pressure, new or existing hypertension, or death compared with regular salt?
Lowering salt intake can reduce blood pressure and the risk for cardiovascular diseases such as stroke. There are low-sodium products available that use other minerals like potassium. This review looks at whether using a salt substitute can improve blood pressure and cardiovascular outcomes.
The researchers did a systematic review of studies available up to May 2018. They found 21 randomized controlled trials (RCTs) with 7,403 people (between 14% to 68% men per trial). The average age of the people studied was 59 years.
The key features of the RCTs were:
The evidence for the effect of low-sodium salt substitutes was very low to moderate, which means that new studies are likely to find different results.
Compared with regular salt use, low-sodium salt substitutes:
In people with or without hypertension, using low-sodium salt substitutes reduced blood pressure but did not affect new or existing hypertension or death.
Outcomes | Number of trials and people | Absolute effect of low-sodium substitutes | Quality of the evidence* |
Systolic blood pressure | 16 trials (1993 people) | Systolic blood pressure was about 7.8 mm Hg lower for people using salt substitutes. | Low |
Diastolic blood pressure | 16 trials (199 people) | Diastolic blood pressure was about 4.0 mm Hg lower for people using salt substitutes. | Low |
New or existing hypertension | 4 (2928) | No difference in effect | Very low |
Death | 2 (2159) | No difference in effect | Moderate |
*Evidence quality was rated using GRADE (Grading of Recommendations Assessment, Development, and Evaluation).
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